Chronic Pain Management

What do I need to know about chronic pain?

Chronic pain is pain that persists or grows worse over a long period. Chronic pain may be caused by cancer, arthritis, surgery, or injuries. Damage to nerves or problems with the body chemicals that send pain messages to the brain can also cause chronic pain. There may be no clear or exact cause of chronic pain. Pain management is an important part of treating your condition.

How is chronic pain diagnosed?

Your caregiver will examine you. He may touch or press different places on your body. A pain diary may help find the cause of your chronic pain. It helps track pain cycles and makes you more aware of when and how the pain starts and ends. The diagnosis of chronic pain is based on low long and how often you have symptoms. You may also need any of the following:

• Pain scale tests: These help measure how much pain you feel. There are many pain scale tests that include numbers or drawings. Your caregiver may ask you to rate the pain on a scale of 0 to 10.
  
  
• Imaging tests: You may need imaging tests to look for the cause of your chronic pain. These include x-rays, a CT scan, or an MRI. You may be given dye to help the pictures show up better. Tell the caregiver if you have ever had an allergic reaction to contrast dye. Do not enter the MRI room with anything metal. Metal can cause serious injury. Tell the caregiver if you have any metal in or on your body.
  
  
• Stimulation tests: These may help find which nerves or muscles are affected by pain. These tests may include electromyography (EMG), nerve conduction studies, and evoked potential (EP) studies.

How is chronic pain commonly treated?

• Medicines:
  
  
  • Acetaminophen: This medicine decreases pain. You can buy acetaminophen without a doctor's order. Ask how much to take and how often to take it. Follow directions. Acetaminophen can cause liver damage if not taken correctly.
    
    
  • NSAIDs: These medicines decrease swelling and pain. You can buy NSAIDs without a doctor's order. Ask which medicine is right for you and how much to take. Take as directed. NSAIDs can cause stomach bleeding or kidney problems if not taken correctly.
    
    
  • Narcotic analgesics: These medicines, which include codeine and morphine, are used for moderate to severe pain.
    
    
  • Anesthetics: These may be injected in or around a nerve. It works by blocking pain signals from the nerves.
  
  
• Surgery and other procedures: Your caregiver may use ultrasound, radio waves, thermal (heat), or laser therapy to relieve your pain. Surgery may also be needed to help relieve your pain. This may include cutting nerves or repairing joints that are the cause of your chronic pain.

What other medicines are used to treat chronic pain?

• Antianxiety medicine: This medicine helps you feel calm and relaxed. It may also decrease pain and help you sleep.
  
  
• Anticonvulsant medicine: This medicine helps control seizures. It may also be used to decrease chronic pain.
  
  
• Antidepressants: These medicines help decrease or prevent the symptoms of depression or anxiety. They are also used to treat nerve pain.
  
  
• Muscle relaxers: This medicine helps relax your muscles. It is also given to decrease pain and muscle spasms.
  
  
• Steroids: This medicine may be given to decrease inflammation that causes pain.

How can I manage chronic pain?

• Heat: Heat helps decrease pain and muscle spasms. Apply heat on the area for 20 to 30 minutes every 2 hours for as many days as directed.
  
  
• Ice: Ice helps decrease swelling and pain. Ice may also help prevent tissue damage. Use an ice pack or put crushed ice in a plastic bag. Cover it with a towel and place it on the area for 15 to 20 minutes every hour as directed.
  
  
• Rehabilitation: This may include physical and occupational therapy. A physical therapist teaches you exercises to help improve movement and strength and to decrease pain. An occupational therapist teaches you skills to help with your daily activities.
  
  
• Electrical stimulation: This uses a device that sends mild and safe electrical signals. These signals decrease pain when used over a painful body part.
  
  
• Counseling and cognitive-behavioral therapy: It may help to talk to a therapist about how you are feeling and things that may cause or increase your pain.

What are the risks of chronic pain?

If chronic pain is not treated, it can decrease your appetite, sleep, energy and ability to do things. It can also affect your mood and your relationships with others. You may feel that your pain will never go away. This can cause a cycle of suffering, sleeplessness, and sadness.

Where can I find support and more information?

• American Chronic Pain Association
  PO Box 850
  Rocklin , CA 95677
  Phone: 1- 800 - 533-3231
  Web Address: http://www.theacpa.org
  

When should I contact my caregiver?

Contact your caregiver if:

• You have a fever.
  
  
• You have problems sleeping.
  
  
• You have chills, a cough, or feel weak and achy.
  
  
• You have nausea or vomiting.
  
  
• Your skin is itchy, swollen, or has a rash.
  
  
• You have questions or concerns about your condition or care.

When should I seek immediate care?

Seek care immediately or call 911 if:

• You feel more pain even after you take your medicine.
  
  
• You feel so depressed that you cannot cope.
  
  
• You feel very anxious or irritable after you take your medicine.
  
  
• You have problems thinking clearly.
  
  
• You have trouble controlling your bowel or bladder.
  
  
• You have severe chest pain and trouble breathing all of a sudden.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

Learn more about Chronic Pain Management